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by Dr Charles
Shaw and Adrian
Published: August 2020, with updates by
Dr Amar Shah
The evolution of
quality in UK health services has been one of consistent technical
advances and complex cycles of values and behaviour. Frequent
shifts in priorities and terminology, especially in the National
Health Service (NHS), have led to relabelling, restructuring and
loss of learning. The key dimensions of quality in healthcare
remain unchanged, although we have seen an evolution of focus from
planning to assurance to a deeper embedding of quality improvement
within today's healthcare system.
Understanding how and why cycles recurred in
the past helps to explain the present and, to some degree, the
future. We can learn, for example, from recurring cycles in NHS
policy, professional attitudes and public expectations. Observers
around the world study closely how the UK, and specifically
the NHS, have trodden this circuitous path. Similar reflection may
also enable policymakers and practitioners in the UK to recognise
where we are now and where we might go next in the quest for
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